정신분열병 환자의 병식과 정신병리

정두훈,송지영,염태호,윤도준,반건호,김종우 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

연구목적 : 정신분열병 환자에서 병식의 결여는 매우 흔한 증상이며, 치료 예후에 큰 영향을 미치는 바. 정신분열병 환자의 병식결여가 어떠한 정신병리적 특성이 있는지를 규명하고자 하였다 이로서 병식결여환자에 대한 이해와 치료적 접근에 기여하고자 한다. 연구방법:. 연구대상은 DSM-lV에 의거한 정신분열병 환자 69명으로서, 이들에게 병식 평가검사척도(Scale to Assess Unawareness of Mental Disorder)와 다양한 정신병리적 측면을 측정할 수 있는 경회 -프랑크푸르트(Kyung Hee-Frankurter Beschwerde Fragebogen . K-FBF) 임상검사를 실시하여, 병식의 유무에 따른 정신병리의 특성을 알아보았다. 연구걸과 : 병식의 유무에 따른 양군간의 성별, 교육정도, 직업 , 종교, 사회경제상태. 유병기간 및 약물용량의 차이는 없었으나, 병식결여군에서 강제입원율이 유의하게 많았고, 입원횟수가 약간 많았다. K-FBF로 측정한 정신병리의 비교에서 병식결여군이 병식획득군에 비하여 정신운동성장애, 지각장애, 차단증상, 언어장애, 인지장애. 선택적 주의력 장애가 유의하게 높았다. 결 론: 정신분열병에서 병식의 결여는 다른 여러 정신병리와 마찬가지로 신경심리학적, 신경생물학적 요인에 의하여 발생하는 증상의 하나로 추정되고 있는 바. 병식이 결여된 환자가 병석을 획득한 환자에 비하여 더 심각한 정신병리를 경험하고 있는 것으로 나타났다. 이들은 비록, 병석이 결여되어 자신의 병에 대해서나 치료의 필요성에 대한 인식이 결여되는 특성을 가진다 하더라도, 이들이 주관적으로 느끼는 증상을 또-FBF를 통해서 알아볼 수 있었다. 이를 통해서 병석이 결여된 환자들은 심각한 신경심리학적. 신경생물학적인 기능장애를 배경으로 하는 인지, 지각, 언어 장애를 갖고 있다는 것을 알 수 있었다. 이로서 정신분열병 환자에서 병식유무 평가뿐 아니라 K-FBF를 이용한 주관적인 증상표현을 통하여 이들이 갖고 있는 정신병리를 파악하는 것이 환자를 이해하는데 도움이 된다고 사료된다. 0bjectives : Patients with poor insight are commonly observed among schizophrenics and they show poor drug compliance and prognosis. This study aimed at examining the characteristics of psychopathology in patients with schizophrenia who have no insight. Understanding the features of inner psychopathology in schizophrenic patients with poor insight, we assumed, could lead to insight-promoting clues. Methods : The subjects consisted of 69 patients with schizophrenia diagnosed by DSM-IV riteria. For identifying insight level in the patients, Scale to Assess Unawareness of Mental Disorder(SUMD) was applied. After subjects were divided into two groups depending upon insight level, psychopathological differences were evaluated by Kyung Hee-Frankfruter Beschwerde Fragebogen(K-FBF), which was known as one of the subjective psychological tests for the schizophrenics. Results : There was no significant differences in demographic variables, duration of illness, and dose of medication between two.groups. However, significantly high rate of involuntary admission and tendency of high frequency of admission were revealed in schizophrenic patients with poor insight. And, also poor insight group showed significantly high scores in the factors of sensori-motor disorder(subscales of psychomotor disorder, perceptual disorder and blocking symptoms included) and in language-cognitive disorder factor(subscales of language disorder and cognitive floating included) compared with patients who have insight. Conclusion : We was assumed that lack of insight in schizophrenics could include one of the symptoms based on neuropsychological or neurobiological abnormalities in brain. Moreover, it was revealed that patients with poor insight evaluated themselves as having more serious psychopathologies than patients who had insight. It has been already known that schizophrenic patients who lack in insight are reluctant to taking psychiatric rare and lack in awareness of their illness. However, this study suggests that their inner psychopathology associated with insight can be understood with the use of subjective psychological test i.e. K-FBF. For understanding the schizophrenic patients who lack in insight, not only checking the insight but also applying the subjective test such as K-FBF seems to be helpful.

통찰 음악교육을 위한 내용과 방법

조성기 한국음악교육공학회 2019 음악교육공학 Vol.0 No.40

Insight is an essential ability for humans to cope with changes and also to overcome crises. This insight has been together with the survival of mankind. In the upcoming future society by artificial intelligence, it is more emphasized together with the creativity, and the deep and high-level of insight is asked for. Thus, this study aimed to understand what should be developed and cultivated in which methods of music education, and also to understand the contents and methods for the insight of music education, in order to increase the insight which would be asked for students in the future. For this, after considering diverse literature on the meanings and process of insight, and the insight education, this study concretely discussed the contents and methods of insight that could be developed by music education. In the results of this study, the contents of music education for insight could include feelings(emotion) as the object of insight, music elements as music itself, and the introspection as the highest level of insight. Regarding the methods of music education for insight, this study set up the process and activity for music education and then examined the example by applying the general stage and process of insight. 통찰은 인간이 변화에 대처하고 위기를 극복하는 데에 반드시 필요한 능력이다. 이러한 통찰은 인류의 생존과 함께해 왔으며, 다가오는 인공지능에 의한 미래 사회에서는 창의력과 함께 보다 더 강조되고 있고 깊고 높은 차원의 통찰이 요구되고 있다. 이에 본 연구는 미래를 살아갈 학생들에게 요구되는 통찰 능력의 신장을 위해 음악 교육에서 무엇을 어떠한 방법으로 기르고 함양시켜야 하는지, 음악교육에서의 통찰을 위한 내용과 방법을 알아보는 데에 그 목적을 두었다. 이를 위해 통찰의 의미와 과정, 그리고 통찰교육에 대하여 다양한 문헌을 고찰하여 보았고, 이를 토대로 음악교육을 통해 기를 수 있는 통찰의 내용과 방법에 대해 구체적으로 논의하였다. 연구 결과로서 통찰을 위한 음악교육의 내용으로 통찰의 대상은 느낌(정서)과 음악 자체로서 음악 요소, 그리고 통찰의 이해력에서 가장 높은 차원인 성찰이 될 수 있음을 밝혔으며, 통찰을 위한 음악교육의 방법으로는 느낌의 통찰과, 음악적 통찰, 심미적 통찰에 대하여 음악교육을 위한 과정과 활동을 설정하고 그 예를 제시하였다.

알코올중독자의 병식 수준과 심리적 특성의 관계

김석산(Seog-San Kim),신재정(Jae-Jung Shin),황인복(In-Bok Whang),채숙희(Suk-Hi Chai) 한국중독정신의학회 2002 중독정신의학 Vol.6 No.1

Objectives:When we treat alcoholism, we frequently meet the alcoholic patients’ defense mechanism such as denial, minimization, projection, rationalization and so on. For successful recovery, alcoholic patients must have the true insight. But most alcoholic patients rarely have it. This study was intended to investigate the relationship between insight level and psychological characteristics in alcoholic patients. Method:The subjects participated in this study were 147 alcoholic patients who were diagnosed as alcohol dependence by DSM-IV and NAST and were admitted to Dasarang Alcohol Hospital, Kwang-ju between April and October, 2001. The subjects were divided into three groups according to insight level. Subjects were surveyed by questionnaire about the sociodemographic data, clinical data, HAIS, alcohol problem scale, self-esteem scale, social support scale, BDI and STAI. Results:Among 147 subjects, 33 (22.4%) were ‘good insight group’, 73 (49.7%) were ‘fair insight group’, 41 (27.9%) were ‘poor insight group’. This study showed the group of lower insight level was the older alcoholic patients. Insight level was higher when the patients’ admission type was voluntary, when alcoholic patients had admitted in the department of internal medicine because of alcohol related physical illness and when frequency of admission was high. Both Lower BDI score and absence of current physical illness were shown in the groups who were higher insight level. The ‘poor insight group’ was shown the highest BDI and STAI scores and the lowest social support scores. Hierarchical multiple regression, which considered sociodemographic, clinical and psychological variables simultaneously, showed that the insight of alcoholics was significantly predicted from frequency of admission, occupational-social problem, age, education and behavior problem. Conclusion:If the insight level is lower, the alcoholic will be more depressed and anxious. To increase the alcoholic patients’ insight, 1) it is effective for them to confront their own occupational-social and behavior problem. 2) we should help alcoholic patients enter to therapy when alcohol problem occur. The sooner, the better.

HAIS(Hanil Alcohol Insight Scale)를 이용한 알코올의존 환자들의 병식 평가

김종성(Jong-Sung Kim),박병강(Byoung-Kang Park),김갑중(Gap-Jung Kim),오미경(Mi-Kyung Oh),이충숙(Chung-Suk Lee),유남재(Nam-Jae Yu),오장균(Jang-Kyun Oh) 한국중독정신의학회 1998 중독정신의학 Vol.2 No.1

Objective:The successful recovery of alcoholics requires a new “self-identity”, which can be built up by and should be based on the true insight which enables them to admit that they are alcoholic. But practically most patients rarely have any level of insight. This study was designed to analyze the insight status of alcoholics and its related factors, and thus to provide the fundamental data which can be used for rehabiliation. Method:Insight status of 60 alcoholics were analyzed, who were admitted to Hanil Alcohol Treatment Center, Taejon between June 1 and August 31, 1997, using HAIS (Hanil Alcohol Insight Scale). Results:1) The mean HAIS scores of 60 alcoholics were 5.05 (±9.19). Among these, 22 (36.7%) had “poor insight”, 29 (48.3%) “fair insight”, and 9 (15.0%) “good insight”. 2) This study showed the lower HAIS scores, the older the subjects were (p〈0.05), while the more educated got the higher HAIS scores (p〈0.001). They showed the higher HAIS scores, the higher the frequency of admission was (p〈0.05), the higher the MAST scores were (p〈0.01). In addition, higher HAIS scores were shown in the groups who have experienced alcohol-related physical illness (p〈0.05) and have participated in the educational programs on alcoholism (p〈0.01) than in other groups who have not, respectively. By the motives of admission, HAIS scores were the highest in those whose motive was voluntary, followed by semi-voluntary and involuntary in a decreasing order (p〈0.01). 3) With the further analyses of many variables shown to be related with HAIS scores using stepwise multiple regression, statistically significant were MAST scores, motives of admission, history of alcohol-related physical illnesses, experience in educational programs on alcoholism (p〈0.05), with the R2 value of 58.0%. Conclusion:This study revealed that most alcoholics (85.0%) had impaired insight, and that to increase the alcoholics’ nsight, much emphasis should be put on such therapeutic efforts as to help alcoholics achieve voluntary admission by persuation and confront their own physical and social consequences, to lead them to the participation in the educational programs on alcoholism.

알츠하이머 치매 환자에서의 병식과 신경정신행동과의 연관성 : A Clinical Research Center for Dementia of South Korea (CREDOS) Study

윤혜연,명우재,송지혜,최준배,강효신,나덕렬,김성윤,이재홍,한설희,최성혜,김상윤,김도관 대한신경정신의학회 2013 신경정신의학 Vol.52 No.1

Objectives The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer’s dementia (AD). Methods We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric,neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to ‘with insight’,‘partial insight’, and ‘without insight’ by interview with caregivers. Results Among the 2607 patients, 990 were included in the ‘with insight’ group, 1191 were included in the ‘Partial insight’ group, and the ‘without insight’ group included 426 patients. The ‘without insight’ group had a significantly higher aggression level than the ‘with insight’ group, but not the ‘partial insight’ group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the ‘Partial insight’ group and the ‘without insight’ group, compared to the ‘with insight’ group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The ‘partial insight’ group showed a lower anxiety level than the ‘with insight’ group (OR=0.63, 95% CI : 0.53-0.75). Conclusion Findings of this study confirmed that insight level was associated with aggression,depression, and anxiety in patients with Alzheimer’ dementia.

통찰 음악교육의 실태 분석

조성기,함인아 한국음악교육공학회 2019 음악교육공학 Vol.0 No.41

In the rapidly-changing future society, the insight is required. The efforts to educate and expand the insight to students are crucial in the subject education. As the music subject uses the time-flowing music in the form of repetition, change, and contrast as its material, and also handles the characteristics of those forms as the contents of education, it could be a very effective subject to teach the insight. Thus, after judging the necessity to understand how the insight education would be performed in school music education, this study researched and analyzed the current states and opinions of insight music education targeting total 78 music teachers of secondary schools in the entire country, and then discussed based on the results of the analysis. In the results of this study, the music teachers highly perceived the necessity of insight music education, and also perceived the importance of aesthetic insight and insight of feeling as the object of insight music education while they showed the low response to the musical insight. The factual survey found out that the insight music education was not performed well. In detail, the musical insight education was not performed well compared to the insight of feeling and aesthetic insight. For the effective insight music education, the appreciation area would be the most suitable out of the contents area. And it would be also needed to support the teachers’ training and also to develop and provide the methods of insight music education. 급변하는 미래 사회에서는 통찰 능력이 요구된다. 미래를 살아갈 학생들에게 통찰 능력을 학습시키고 신장시키려는 노력이 교과교육에서 강조되고 있다. 음악교과는 시간 속을 반복과 다양한 형태로 변화하며 흘러가는 음악을 재료로 하고 그 형식들의 특성을 교육 내용으로 다루기 때문에 통찰을 학습시키는 데에 매우 효과적인 교과가 될 수 있다. 이에 본 연구는 통찰교육이 학교 음악교육에서 어떻게 이루어지고 있는지 알아볼 필요가 있다고 판단하고, 전국 중등학교 현장의 음악교사 78명을 대상으로 통찰 음악교육의 실태와 의견을 조사하여 분석하고 그 분석 결과를 토대로 논의하였다. 연구 결과, 음악교사들은 통찰 음악교육이 매우 필요하다고 인식하고 있는 것으로 나타났으며, 통찰 음악교육의 대상으로서 심미적 통찰과 느낌의 통찰이 중요하다고 인식하고 있었으나 음악적 통찰에는 낮은 반응을 나타냈다. 실태 조사에서는 통찰 음악교육이 잘 이루어지지 않는 것으로 파악되었으며, 세부적으로 음악적 통찰을 위한 교육이 느낌의 통찰과 심미적 통찰에 비하여 잘 이루어지지 않고 있음이 확인되었다. 효과적인 통찰 음악교육을 위해 내용 영역 중 감상 영역이 가장 적합한 것으로 조사되었고, 교사 연수를 지원해 주고 통찰 음악교육 방법을 개발하여 제공해 줄 필요가 있는 것으로 분석되었다.

만성 남자 정신분열병 환자의 병식 정도와 기질 및 성격 유형과의 관계

강여화,김봉조,손진욱 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

연구목적 : 남자 만성 정신분열병 입원 환자에서의 병식 정도와 기질 및 성격유형간의 관련성을 규명하고자 한다. 부가적으로 병식 정도에 따른 사회 인구학적 변인 및 질병 연관 변인의 차이를 알아보고자 한다. 연구방법 병식 평가를 위해 McEvoy등이 고안한 '병식과 치료태도에 대한 설문(ITAQ : Insight and Treat-ment Attitudes Questionnaire)'과 Amador 등이 고안한 병식 평가 검사(SUMD : Scale to As-sess Unawareness of Mental Disorder)를 이용한 구조화된 면담을 시행하였다. 다음, Cloninger의 기질-성격 철도(TCI : Temperament and Character inventory) 한국판을 이용하여 기질 및 성격특성을 측정하였다. 또한 병록지 검토와 면담을 통해 인구학적 변인 및 질병 연관 변인에 관한 자료를 얻었다. DSM-Ⅳ 진단기준에 의한 최종 분석의 대상이 된 환자는 113명이었다. 병식의 정도에 따라 병식이 높은 군(중간값 11점 이상)과 낮은 군(11점 이하)으로 양분하였다. 연구결과 1) ITAQ 병식 점수에 따른 양군의 비교에서 통계적으로 유의한 차이를 보인 척도는 '새로운 것을 추구하는 성향'이었다. 2) ITAQ 병식 점수와 위험 회피적 성향 사이에서 유의한 상관관계가 있었고, '새로운 것을 추구하는 성향'과는 유의한 음성적 상관관계를 보였다. 하지만, 후천적으로 결정되는 성격 척도 사이에서는 통계적 유의성이 없었다. 3) 질병 연관 변인들 중 첫 발병 나이, 입원 형태, 유병기간, 현재 입원기간, 약물투여량은 양군간에 통계적으로 유의한 차이가 있었다. 결 론 본 연구 결과는 새로움 추구 성향이 높고 위험 회피 성향이 낮을수록 낮은 병식을 가질 수 있다는 병식 정도에 대한 기질특성의 영향을 시사한다. 그러므로 병식의 평가 단계에서 기질 유형을 파악하는 것이 임상적으로 의미가 있을 것이다. 앞으로 정신분열병 환자의 기질 및 성격 유형에 관한 지속적인 연구가 필요할 것이다. Objectives : This study was conducted to investigate the relationship of insight level with temperament and character pattern in chronic male schizophrenics. In addition, we tried to examine demographic variables and illness-related variables which may affect the level of insight. Methods : To assess insight level by psychiatrists, Insight and Treatment Attitudes Question-naire(ITAQ), Scale to Assess Unawareness of Mental Disorder(SUMD) were applied. Tem-perament and character patterns were evaluated by the Korean version of Cloninger's self-rated Temperament and Character Inventory(TCI). The authors investigated the correlations between insight level, and scores of temperament and character dimensions. Data on the demographic and illness-related variabres for the subjects were gathered from hospital records and clinical interviews. A total of 113 patients with schizophrenia according to DSM-Ⅳ criteria was analyzed. The insight level was dichotomized into good(≥median value of 11) and poor insight group(<11). Results : 1) There was a significant difference between good insightgroup and poor insight group in novelty seeking dimension in TCI. 2) There was a significant negative correlation between novelty seeking scores by TCI and insight scores by ITAQ(rs : Spearman correlation coefficient=-0.20, p<0.05). 3) Significant differences between good and poor insight groups were identified in diverse clinical variables such as age at onset of illness, mode of hospitalization, duration of illness, current length of stay, and dosage of drug. Conclusion : The results suggest that high scores in the temperament dimension of novelty seeking and low scores in the temperament dimension of harm avoidance may influence poor insight in patients with chronic male schizophrenia. Therefore it is clinically valuable for us to assess the pattern of temperament at the stage of insight evaluation. The authors suggest that further studies on temperament and character in schizophrenia is needed.

알코올 의존 환자의 병식 상태에 따른 선별 검사의 민감도

조규철,김종성,정진규,김성수,이정길,최동현 대한가정의학회 2010 Korean Journal of Family Medicine Vol.31 No.7

Background: Alcoholism screening tests are commonly used in primary medical care. This study examined how much the level of insight of alcohol-dependent patients would impact on the sensitivity of alcoholism screening tests. Methods: The sample consisted of 122 subjects who had been diagnosed with alcohol dependence and who completed Alcohol Use Disorders Identification Test (AUDIT), and CAGE questionnaire. AUDIT positive was defined as a score of 20points or above and CAGE positive, 3 points or above. Insight level was classified as poor, fair, and good using the Hanil Alcohol Insight Scale (HAIS). Positive rates on the AUDIT and CAGE were analyzed according to the level of insight. Results: In good insight group, the sensitivity of AUDIT and CAGE identified 96.9% and 96.9% of the participants as alcohol dependence, respectively. In fair insight group, those were 92.7% and 96.4%, respectively. However, in poor insight group,these decreased substantially to 62.9% and 65.7%, respectively. After adjusting for general characteristics on the basis of good insight group, we found that the possibility of positive on the AUDIT was significantly lower in poor insight group (Odd ratios [OR], 0.025; 95% confidence interval [CI], 0.002 to 0.411). Also, the possibility of positive on the CAGE was significantly lower in poor insight group (OR, 0.016; 95% CI, 0.001 to 0.358). Conclusion: Alcohol-dependent patients with poor insight showed a high rate of false negatives in alcoholism screening tests. These suggest that primary care physicians should be careful in interpreting the results of alcoholism screening tests. 연구배경: 일차 진료에서 알코올리즘을 선별하는 도구는 흔히 사용된다. 본 연구는 알코올리즘 선별 검사들의 민감도가환자의 병식 상태에 따라 어떻게 영향을 받는지에 대해 알아보고자 하였다. 방법: 알코올 의존으로 진단된 122명의 환자들을 대상으로하였다. 알코올리즘 선별 검사와 함께 병식 상태를 평가하였다. 알코올리즘 선별 검사는 Alcohol Use Disorders Identication Test (AUDIT)와 CAGE 설문지를 이용하였다. AUDIT는 20점이상, CAGE는 3점 이상을 알코올 의존 양성으로 하였다. 병식상태는 Hanil Alcohol Insight Scale을 이용하여 부정 병식 군, 병식 부분 형성 군 그리고 병식 형성 군으로 분류하였다. 결과: 부정 병식 군(35명)의 AUDIT에 대한 민감도는 62.9%였으며 CAGE에 대한 민감도는 65.7%이었다. 병식 부분 형성군(55명)의 AUDIT에 대한 민감도는 92.7%, CAGE의 민감도는 96.4%이었다. 병식 형성 군(32명)의 AUDIT에 대한 민감도는 96.9%이었으며, CAGE의 민감도 역시 96.9%였다. 병식 형성군 대비 부정 병식 군의 AUDIT 설문지의 양성 비율이 유의하게 낮았다(Odd ratios [OR], 0.025, 95% condence interval [CI],0.002-0.411). CAGE 설문지의 양성 비율도 부정 병식 군에서유의하게 낮았다(OR, 0.016; 95% CI, 0.001-0.358). 결론: 알코올 의존 환자의 병식 상태가 낮은 경우 알코올리즘선별 검사의 위 음성이 높았다. 이러한 결과는 일차 진료 의사가 알코올리즘 선별 검사 결과를 해석함에 있어서 주의를 기울여야 함을 암시한다.

정신분열증 환자의 병식획득과 인격특성

박종득,송지영 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.5

연구목적 : 정신분열증 환자중에는 병식을 갖고서 치료에 잘 순응하며 예후가 좋은 경우가 있는 반면에 병식이 부족하여 치료에 어려움을 겪는 경우가 있다. 저자들은 병식획득에 주요 요소가 무엇인지를 알기 위하여, 정신분열증 환자가 병식을 획득하는 데에는 이들이 갖고 있는 심리적 의미로서의 자아강도의 힘보다는, 신경생물학적인 근거를 갖고 있다는 특정 인격형태와 관련이 있을 것이라는 가설을 세우고 이를 검증하고자 하였다. 방 법 : 연구대상은 DSM-Ⅳ 진단기준에 의거한 정신분열증 환자 60명에서, Amador등 (1994)이 고안한 병식 평가검사척도(Scale to Assess Unawareness of Mental Disorder ; SUMD)를 이용하여 병식이 있는 군 30명과 없는 군 30명으로 나누었다. 병식획득이 자아강도와 관련되는지를 알아보기 위하여 Barron의 자아강도 검사를 시행하였으며, 세가지 차원의 인격형태를 측정하는 TPQ를 시행하여 양군을 비교하였다. 그리고 환자군의 TPQ 특성과 일반인과의 차이를 알아보기 위하여, 일반인과 대학생 453명을 대상으로한 연구결과와 비교해 보았다. 결 과 : 병식획득 유무에 따른 양군간의 연령, 성별, 입원횟수, 교육기간, 투여 약물용량 등에서 차이가 없었다. 자아강도는 양군간에 차이가 없었으며, TPQ에서는 새로움 추구, 손해회피 차원은 병식획득군과 병식결여군에서 양군간에 유의한 차이가 없었다. 그러나 보상의존 차원에서는 병식결여군이 병식획득군 보다 유의하게 높았다. 또한 본 연구 환자군과 일반인의 TPQ 특성을 비교해본 바, 손해회피 요인, 새로움 추구 요인에서는 차이가 없었으나, 보상의존 요인에서 일반인과 병식획득군보다 병식결여군에서 유의하게 높은 수치를 보였다. 결 론 : 정신분열증 환자군에서의 병식획득 결여는 Cloninger의 삼차원 인격형태 이론에서 보상의존 차원과 연관이 있음을 시사한다고 할 수 있다. 본 연구는 이들 인격차원 중에서 이제까지 알려진 도파민, 세로토닌과 관련된 인격차원이 아닌 노에피네프린과 관련된 인격특성이 정신분열증 환자의 병식획득 결여와 관련이 있음을 시사한다. 즉 병식획득에는 자아기능의 힘보다는 뇌의 신경생물학적 특성에 기반을 둔 특정 인격형태와 관련되리라고 추정할 수 있다. Objectives : We attempted to investigate personality characteristics influencing insight acquisition in patients with schizophrenia. Methods : Tridimensional personality questionnaire(TPQ) for neurobiologically based personality characteristics assessment and Barron's ego strength test were administrated to 30 patients with schizophrenia who had good insight and 30 patients who had poor insight. Each group was also compared with 453 normal health controls. Results : There were no significant differences between good and poor insight acquisition groups on ego strength. Poor insight acquisition group showed significantly higher reward dependence dimension on Tridimensional Personality Questionnaire than good insight acquisition group, though the other two personality dimensions showed no difference. The good insight group showed no difference on three TPQ dimensions from normal healthy control group. However, the poor insight group demonstrated higher score in reward dependence dimension than the healthy control group but not in the other two dimensions. Conclusion : These results suggest that neurobiologically determined personality characteristics rather than ego strength would be closely related with insight acquisition in schizophrenia. Reward dependence as groups of behavioral characteristics, mainly derived from central norepinephrine mediated behavior would be related with insight formation. The roles of norepinephrine in schizophrenia have not been fully understood yet. Further understandings regarding insight formation process and role of norepinephrine in schizophrenia could give some clues on insight acquisition in patients with schizophrenia.

기업가의 통찰력이 중소기업 지속가능경영에 미치는 영향에 관한 연구

김원주(Wonju Kim),양동우(Dongwoo Yang) 대한경영학회 2021 大韓經營學會誌 Vol.34 No.10

경영예측과 판단이 어려워지고 있는 환경변화 속에서 기업이 생존률을 높이고, 기업발전의 지속 성장을 위해서는 기업가의 통찰력을 이해할 필요가 있다. 기업가의 통찰력은 경험, 직관 등 여러 요소들의 상호작용을 거쳐 기업경영 의사결정에 영향을 미침으로써 기업을 ‘지속가능한 기업’으로 성장시키는 중요한 역할을 한다. 통찰력은 기업가 혼자의 노력을 통해서도 가능하지만 구성원과의 사회적 상호관계내지 연대를 통해 성장하고 구체화되는 과정을 거친다. 통찰력이 폐쇄적 환경보다 개방적 환경에서 더 적합한 생태토양을 기반으로 하여 성장함을 의미한다. 이와 관련하여 통찰력 구현을 위한 주위 환경 요소들 가운데 기업 내 집단 간 태도인 사회지배지향성에 관한 내용을 살펴볼 필요가 있다. 사회지배 지향성은 사회 내 특정 집단이 다른 집단에 대해 지배력을 행사하거나 불평등을 지지하는 성향으로 사회지배성향이 높은 기업가는 그렇지 않은 기업가보다 온전한 통찰력 형성 내지 구현이 어려울 것이다. 아울러 종속변수로써 경제적 책임, 사회적 책임, 환경적 책임을 그 구성요소로 하는 지속가능경영을 제시하였다. 본 연구에서는 통찰력, 사회지배지향성, 지속가능경영의 이론적 고찰을 하고, 이들 상호간의 관계를 다음과 같이 실증 분석하였다. 첫째, 통찰력과 사회지배지향성의 관계분석 결과, 통찰력의 전략적 관심, 멘탈 시뮬레이션은 사회지배지향성의 사회적 위계성에 유의하였으나, 통찰력의 참여적 의사결정은 사회적 위계성에 유의하지 않은 것으로 나타났다. 또한 통찰력의 전략적 관심, 참여적 의사결정이 사회지배지향성의 사회적 반평등성에 유의하지 않은 반면, 통찰력의 멘탈시뮬레이션은 사회지배지향성의 사회적 반평등성에 유의한 것으로 나타났다. 둘째, 통찰력과 지속가능경영의 관계분석 결과, 통찰력의 참여적 의사결정이 지속가능경영에 유의하게 나타났으나, 전략적 관심과 멘탈시뮬레이션은 지속가능경영에 유의하지 않은 것으로 나타났다. 셋째, 사회지배지향성과 지속가능경영의 관계분석 결과, 사회적 위계성과 사회적 반평등성은 지속가능경영에 유의한 것으로 나타났다. It is necessary to understand the insight of entrepreneurs in order for companies to increase their survival rate and to achieve sustainable growth in corporate development amid changes in the environment in which business prediction and judgment are difficult. Entrepreneur’s insight plays an important role in growing a company into a ‘sustainable company’ by influencing corporate management decision-making through the interaction of various factors such as experience and intuition. Insight is possible through the entrepreneur’s own efforts, but it goes through the process of growing and materializing through social interaction or solidarity with members. It means that insight grows on the basis of ecological soils that are more suitable in an open environment than in a closed environment. In this regard, it is necessary to examine the social domination orientation, which is an attitude between groups within a company, among environmental factors for the realization of insight. Social domination orientation is a tendency in which certain groups in society exercise dominance over other groups or support inequality. In addition, as a dependent variable, sustainability management with economic responsibility, social responsibility, and environmental responsibility as its components was presented. In this study, theoretical considerations of insight, social domination orientation, and sustainable management were conducted, and the relationship between them was empirically analyzed as follows. First, as a result of analyzing the relationship between insight and social domination orientation, strategic interest of insight and mental simulation showed that the social hierarchy of social domination orientation was significant, but participatory decision-making of insight did not have significant significance on social hierarchy. In addition, the strategic interest of insight and participatory decision-making did not show significance in the social anti-equality of the social domination orientation, whereas the mental simulation of the insight was significant in the social anti-equality of the social domination orientation. Second, as a result of analyzing the relationship between insight and sustainability management, it was found that the participatory decision-making of insight was significant in sustainability management, but strategic interest and mental simulation were not significant in sustainability management. Third, as a result of analyzing the relationship between social domination orientation and sustainable management, social hierarchy and social anti-equality were found to be significant in sustainable management.